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DxF Press Release – January 31

Health and Social Services Entities Begin Statewide, Secure, Real-Time Exchange of Electronic Health Records to Support a Healthier California


The Data Exchange Framework (DxF) was signed into law on July 27, 2021 by Governor Gavin Newsom to require the secure, real-time exchange of health and social services information throughout California. Beginning January 31, 2024, many healthcare entities in the state are required to share information with other providers and payers under DxF Policies and Procedures, setting the stage for coordinated, continuous, and informed care for all Californians.

SACRAMENTO, CA — Today, the California Health & Human Services Agency (CalHHS) Center for Data Insights and Innovation (CDII) marks the start of statewide, secure data exchange of health and social services information required under the Data Exchange Framework (DxF). This key step towards a Healthy California for All puts people at the center of modern healthcare that expands coverage, advances equity, and improves connections between health and social services entities.

Over the past two and a half years, CDII executed a transparent, public process that brought together key stakeholders, advocates, and the interested public to develop the Policies and Procedures of the groundbreaking DxF.

“Governor Newsom and the legislature challenged us to develop a framework that modernizes California’s information exchange between and among health and social services providers to improve coordination and continuity of care,” said Dr. Mark Ghaly, Secretary of CalHHS. “Accessibility to a patient’s health history drives more informed decision making and increasing a patient’s access to their own health and social services data fosters greater participation in their own healthcare decisions. This historic moment would not have been possible without the commitment of our partners, including stakeholders, providers, payers, and advocacy organizations. By working together, we’ve met the charge and delivered for Californians.”

WHAT THIS MEANS FOR CALIFORNIANS: The DxF is a remarkable advancement in how our health system supports Californians. It will improve care and health outcomes for all Californians by giving providers the information needed to provide more informed care. This is accomplished by bringing existing standalone health systems, providers, and social services together seamlessly and enabling real-time, secure data exchange. The DxF will enable a more modern patient experience. The burden of carrying one’s records between appointments will be eased, as well as the reliance on recalling your own health history as a starting point for care when seeking a new provider. Learn more about how the DxF can support a healthier California.

BACKGROUND: Over the past two and a half years, CDII led the effort to create the DxF with a bold vision for a connected California that would transform healthcare, expand coverage, and improve connections between health and social services entities. The DxF is not a new technology or centralized data repository; instead, DxF Participants are agreeing to new rules of the road for securely and appropriately exchanging health and social services information to best serve patients and join a shared commitment to providing safe, effective, whole-person care across California.


  • Governor Newsom Signs AB 133— Establishing California’s First-Ever Requirement to Securely Share Data Between Health and Social Services Organizations in California
    AB 133 is transformative for healthcare in California, inspiring the creation of a framework that enables the real-time, secure exchange of health and social services information across the state.
  • Accountable Development of the DxF Began by Recruiting A Diverse Set of Industry Leading Experts in Health and Social Services Data Exchange and Delivery
    An inclusive engagement process has ensured that implementation is open, transparent, and public. Experts were assembled from both public and private health and social services organizations to fill the Stakeholder Advisory Group and the Data Sharing Agreement (DSA) Policy & Procedure Subcommittee to ensure a comprehensive and robust process to guide the development and implementation of the DxF. Effective governance has continued with the Implementation Advisory Committee.
  • Prominent Statewide Health And Human Services Associations Led Equitable Outreach, Guidance, and Education on the DxF to Health Organizations
    CalHHS awarded grant funding to 8 associations, with a focus on assisting those operating in under-resourced and underrepresented communities. Activities funded by these grants included the development and distribution of educational materials through targeted activities, such as: Webinar Series, Coaching Hours, Health Information Technology Conferences, Learning Collaboratives, Data Exchange Framework Bootcamps, Educational Forums, FAQ, and Knowledge Resource Centers.
  • CDII Awarded $47 Million in Grants to Support Data Exchange Needs of Health and Social Services Organizations Serving Under-Resourced, Historically Marginalized, and Underserved Communities
    The DSA Signatory Grants Program was established to provide Participants who were most likely to be impacted by the transition to modern data exchange with resources to address critical operational and technical barriers to DxF implementation. The program ensured all health and social services entities had support available for smooth implementation of the DxF—applications representing over 800 signatories have been received and all funds allocated will be disbursed.
  • CDII Designated Nine Qualified Health Information Organizations (QHIOs) To Fill Gaps in California’s Data Exchange Infrastructure
    QHIOs are set to provide data exchange capabilities that many health and social services entities did not previously possess, especially those serving historically marginalized populations and underserved communities. Any Participant may elect to use a QHIO to help meet their data exchange requirements, creating an accessible path to modern data exchange for all. Connecting these entities and enabling their participation broadens the reach of the DxF across the state, and ensures every patient benefits from informed, coordinated care.
  • CDII Hosted Monthly Public Webinars and Office Hours Over the Past Two Years to Provide Details, Updates, and Direct Q&A For Health and Social Services Entities and Interested Parties
    The multichannel hands-on assistance highlights CalHHS’ commitment to putting forth every effort to ensure health entities were fully supported in understanding the DxF, their role within it, and the funding available for technical support.
  • CalHHS Monumental Efforts Over The Past Two and a Half Years Reflect the State’s Commitment to Equitable, Modern Health
    The collective efforts of CalHHS, CDII, industry stakeholders, providers, payers, advocacy organizations, and years of individual efforts to champion secure, seamless data exchange, have led to today’s successful adoption of the DxF by thousands of health entities. Californians in every corner of the state will reap the benefit of this collaboration and the resulting improved care.

 HOW IT ALIGNS WITH OTHER EFFORTS: At the federal level, the Trusted Exchange Framework and Common Agreement (TEFCA) aims to create a seamless and secure flow of patient health information to drive change in health care. While TEFCA lays the foundation, California is playing an essential role in accelerating this work. California’s DxF considers and aligns with the standards set out by TEFCA. Participating in TEFCA enables a health care provider in California to help meet the statutory clinical data exchange obligations of the DxF. The collaboration between TEFCA and the DxF establish data exchange models and governing approaches that enable health care and social services providers to securely share information with each other in California, regardless of which network or technology they happen to use.

WHAT COMES NEXT: As many Signatories begin the secure exchange of health information today, some entities, including physician practices with fewer than 25 physicians, acute psychiatric hospitals, and rural general acute care hospitals, may elect to begin participating in the DxF on or before January 31, 2026.

To learn more about the Data Exchange Framework, visit

For details and resources on how the Data Exchange Framework can help improve healthcare and social services for all Californians, visit CDII DxF Website to review materials, join a webinar, and sign up for updates.